When a trainee has satisfactorily completed specialty training for general practice, and is competent to enter independent practice in the United Kingdom without further supervision they will be issued with a certificate of completion of training (CCT) and full Membership of the Royal College of General Practitioners (MRCGP).

To achieve MRCGP trainees must complete an Applied Knowledge Test (AKT), a Clinical Skills Assessment (CSA) and Workplace Based Assessment (WPBA). Each of the components test different competences using validated assessment methods. Together the components cover the spectrum of knowledge, skills, behaviours and attitudes defined by the GP Specialty Training curriculum.

Whilst seeing patients and working with your team you will have experiences that will help you develop your knowledge and skills. With the help of your ePortfolio, WBPA and your supervisors you will learn how to analyse these experiences and link them with certain sections of the curriculum.

Over time you will cover more and more sections of the curriculum so that by the end of the training you will have covered every section at least a few times. Your ePortfolio will help you to map your curriculum coverage and show you areas to focus on.

“The Condensed Curriculum Guide” The official guide and essential companion to the RCGP Curriculum for General Practice, covering the knowledge, skills and attitudes that every doctor needs to become an effective general practitioner.

InnovAIT The RCGP magazine for GP trainees. InnovAIT rotates through the whole nMRCGP curriculum on a three year cycle to support and assist the learning and development of AiTs as they progress through training.

Background

Workplace Based Assessment (WPBA) is a set of tools that evaluate a trainee’s progress over time. It captures your performance at various points in time in a structured and formative way on the ePortfolio.

Together with the help of your supervisor you will be able to identify further learning needs through WPBA.

The portfolio can seem quite daunting to start with. We will provide regular sessions to support you in getting the most from it. If you have concerns about how to use your portfolio please ask.

Timely completion of log entries and regular updating of the ePortfolio is YOUR responsibility. This is your proof to show that you are gaining and developing further the skills you will need as a qualified GP. Failure to do this will result in unsatisfactory progress and referral to the Deanery which can lead to the need for extension of your training or ultimately removal from the programme.

CBD

Case based discussion (CbD)

This is a structured interview with a GP, consultant or registrar designed to explore your professional judgement in clinical cases. You select and present the cases and the assessor will ask questions to elicit evidence of competence.

You must do a minimum of 3 CBDs per 6 months in ST1 and ST2 and 6 per 6 months in ST3.

CEX

Mini-Clinical Evaluation Exercise (Mini-CEX)

A consultant or registrar (ST4 or above) observes you for a 15 minute snapshot of a doctor/patient interaction in order to assesses clinical skills, attitudes and behaviours in a secondary care setting. The assessor will give you immediate feedback.

You must do a minimum of 3 mini-CEX per 6 months in a hospital rotation

COT

Consultation Observation Tool (COT)

The COT tool is for use in GP placements. A consultation is observed by your trainer either directly or on video and this leads to discussion and feedback. The trainer rates the consultation according to a set of COT criteria.

You must do a minimum of 3 COTS per 6 months in an ST1 or ST2 GP post and 6 per 6 months in ST3.

CEPS

Clinical Examination and Procedural Skills (CEPS)

Trainees are expected to demonstrate progress in applying psychomotor skills both in the GP workplace and also within the CSA. When they complete their training they must be competent to apply their skills unsupervised however complex the clinical context might be.

Trainees are expected to discuss their learning needs during placement planning meetings and to record their plans in the learning log and PDP. The range of examinations and procedures and the number of observations will depend on the needs of the trainee and the professional judgment of the educational supervisor. Observation and assessment of Clinical Examination and Procedural Skills may be made by clinical supervisors and other colleagues (including senior nurses and trainees at ST4 or above).

You must document Clinical Examinations and Procedural Skills in your learning log. These need to be linked to the relevant curriculum headings and will need to include a range of entries from specific areas, for example cardiovascular/ respiratory / children / the elderly and patients with mental health problems.

There is no prescribed list of Clinical Examinations or Procedural Skills and no minimum number of assessments. But learning logs will need to include breast examinations and the full range of male and female genital examinations as these are required by the GMC. The ES will be able to link these to the competency area for Clinical Examinations and Procedural Skills.

In the ESR the ES will also be asked three questions within the skills log section of the review. In particular they will be required to comment on the trainee’s skills in conducting breast examination and the full range of female and male genital examinations. A trainee will need to be competent for licensing in Clinical Examinations and Procedural Skills to obtain their Certificate of Completion of Training.

MSF

Multi-source Feedback (MSF)

The Multi-Source Feedback (MSF) tool provides a sample of attitudes and opinions of colleagues on the clinical performance and professional behaviour of the GPStR. It helps to provide data for reflection on performance and gives useful feedback for self-evaluation.

PSQ

Patient Satisfaction Questionnaire (PSQ)

The PSQ is for use in GP placements. This tool provides feedback to GPStRs by providing a measure of the patient’s opinion of the doctor’s relationship and empathy during a consultation. The evidence provided is useful in helping trainer and GPStR to address needs and facilitate educational development during the training period.

CSR

The Clinical Supervisor’s Report (CSR)

The ePortfolio has a section for the clinical supervisor to write a short structured report on the GPStR at the end of each hospital post. This covers: the knowledge base relevant to the post, practical skills relevant to the post and the professional competences.

ESR

The Educational Supervisor’s Report (ESR)

Summarises your progress and is used to inform the ARCP panel (see ARCP tab) about progress.

Applied Knowledge Test (AKT)

This is a multiple choice style exam that tests your knowledge base.

The AKT may be taken during ST2 or later and is available to take three times a year.

The test is a three-hour multiple-choice test of 200 items. It is computer-based and delivered at 150 Pearson VUE professional testing centres (driving test centres) around the UK.

Approximately 80% of question items will be on clinical medicine, 10% on critical appraisal and evidence based clinical practice and 10% on health informatics and administrative issues. All questions will address important issues relating to UK general practice and will focus mainly on higher order problem solving rather than just the simple recall of basic facts.

The CSA is a half day high-fidelity OSCE style assessment. Each candidate consults with 13 patients (trained role-players). The cases are all validated cases designed to test your clinical, professional, communication and practical skills.

The CSA may only be attempted when the trainee is in the ST3 stage of specialist training or later and is available to take throughout the year from November to May. It is taken at the RCGP’s headquarters in London.

The ePortfolio of each trainee carries the evidence that is reviewed and considered by the Oxford deanery ARCP panel at least once every year. Reviews are conducted more than annually if there is a need.

The panel consists of representatives of GP education in the Oxford deanery, including programme directors, trainers and lay members and external assessors. The ARCP panel will review your ePortfolio including your evidence, assessments, educators comments and reports and the quality of your reflective log entries. This will allow panel to assess your progress against the competencies and decide whether you have made satisfactory progress to proceed to the next training year. Should the outcome not be satisfactory, you and your trainer will be called to a face-to-face meeting with panel during which panel will decide whether you can proceed or whether they will recommend an extension to your current level of training.

Trainees who pass WPBA at final review and also have a pass in the AKT and CSA will be recommended as eligible to apply for certification of completion of training (CCT), inclusion in the General Medical Council’s GP Register and membership of the Royal College of General Practitioners. The GMC will only allow you to go onto their GP register when you have your CCT and inclusion on this register is essential for working as a fully fledged GP.

The GP ARCP panel have generated the following forms to be used by trainees prior to their annual and gateway ARCPs. This is to try and prevent outcome 5 (insufficient evidence). The forms are a summary of the mandatory evidence required set out as a table that can be completed and uploaded to the ePortfolio. This is just the minimum mandatory evidence however and not all that is required or considered at panel, as it does not look at the quality of the log, the curriculum or competency coverage or the ESs review. It is merely a summary/checklist of the minimum evidence needed pre panel to avoid an outcome 5.

Also available are forms to summarise the evidence from the COTs/Mini-CEX and CbDs. Again in order to reduce duplication of work we would like to encourage the trainees to complete these and upload them to the portfolio. It is suggested that they are all attached to a Professional conversation ePortfolio log entry titled ARCP/ESR Review preparation.